Active NPI
Jill Andrea Ballesteros- Bowman
- Professional Counselor
- Washington, DC
National Provider Identifier
1003466798
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- PRC200001884
- Practice address
- 1140 3Rd St NE
Washington, DC 20002-6274 - Phone
- (202) 468-8823
- NPI assigned
- Sep 16, 2019
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | PRC200001884 | DC | Primary |
| Counselor | 101Y00000X | LPC013744 | GA |
Addresses
Primary practice location
1140 3Rd St NE
Washington, DC 20002-6274
Mailing address
3205 Helena Springs Ave Apt G
Augusta, GA 30909-9350
Phone (323) 392-2190
Other practice location 1
2808 Hillcreek Dr
Augusta, GA 30909-6484
Phone (706) 733-0333
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LPC013744 | GA | MD | Counselor |
| PRC200001884 | DC | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1568592000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1718841600000",
"number": "1003466798",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3205 HELENA SPRINGS AVE APT G",
"city": "AUGUSTA",
"state": "GA",
"postal_code": "309099350",
"telephone_number": "323-392-2190"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1140 3RD ST NE",
"city": "WASHINGTON",
"state": "DC",
"postal_code": "200026274",
"telephone_number": "202-468-8823"
}
],
"practiceLocations": [
{
"address_1": "2808 Hillcreek Dr",
"address_purpose": "LOCATION",
"city": "Augusta",
"state": "GA",
"postal_code": "309096484",
"country_code": "US",
"telephone_number": "706-733-0333",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "BALLESTEROS- BOWMAN",
"first_name": "JILL",
"middle_name": "ANDREA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-09-16",
"last_updated": "2024-06-20",
"certification_date": "2024-06-20",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "DC",
"license": "PRC200001884",
"primary": true
},
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": "GA",
"license": "LPC013744",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Washington, DC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.